Patient Relations Representative - Medical Billing

Position Overview

reCLAIM Mission – We reward our staff and encourage team building and professional development. We invest in the stock of our employees and growth is the hallmark of our business model. We want you to enjoy coming to work and we are looking for long-term employees. reCLAIM Billing Solutions believes in equal opportunity for every applicant and encourages diversity!

The Patient Relations Representative (PR Rep) acts as a line of defense against data entry and billing errors. The #1 goal is to ensure accurate billing. In this role you will take delegated phone calls, assist patients in understanding their bills, and correct software information to secure proper claim payments from insurance.

Key Responsibilities

• Answer patient phone calls from the queue and engage in a cheerful, professional manner.
• Accurately inform patients why they owe a bill.
• Correct billing or data entry errors to prevent inaccurate patient charges.
• Utilize downtime between calls to proactively work on projects, such as verifying patients’ addresses or insurance details.
• Call patients with balances over $500 to offer or set up payment plans as an alternative to collections.
• Process patient payments using the credit card merchant services software.
• Offer payment plans or coordinate with supervisors regarding reduction requests for patients in need.
• Perform adjustments to patient balances only when authorized by a supervisor.
• Collaborate with collection agencies and respond to their information requests.
• Respond to patient inquiries submitted via the portal or email.
• Navigate insurance, third-party, and EHR portals to obtain Patient Health Information (PHI) while maintaining HIPAA standards.
• Maintain and monitor trainings and processes pertaining to the PR Rep position.

Required Qualifications

• 2 years of relevant experience or successful completion of an externship through reCLAIM Billing Solutions.
• Revenue Cycle Management (RCM) knowledge.
• Understanding of the claim cycle and claim processing.
• Critical thinking and problem-solving skills.
• Meticulous note-taking and strong organizational skills.
• Drive to generate results and a fast learner.
• Ability to work in a fast-paced environment while maintaining a sense of urgency.
• Client-centered mentality with a passion for customer service.
• Commitment to continuous improvement and career advancement.

Preferred Qualifications

• Bachelor’s degree.
• Spanish speaker.
• Organized and detail-oriented.
• Logical, self-starter with a proactive approach to achieving goals.
• Enthusiastic about growth and team collaboration while taking direction well.
• Keeps updated with healthcare industry trends and insurance policies.
• Punctual and reliable in meeting responsibilities.

Benefits & Perks

• Medical benefits: reCLAIM offers Anthem PPO & HMO.
• Dental benefits: Renaissance Dental with PPO network.
• Vision benefits: Renaissance with VSP Vision Care network.
• Supplemental coverage: Hospital Indemnity, Accident Expense, and Short-Term Disability Income.
• Retirement benefits: 401k options available.
• Other benefits: Catastrophic insurance, PTO accrual of 40 hours per year (2,080 worked hours), and 16 hours of sick time annually.